JCA Child Pre Registration slip
Print Child's Name here:______________________________
Date of event: _____________________
Must be filled in and correct
Circle your class
Boy's Youth (12-17 yrs) Cub (8 to 11 yrs)
Girl's Youth Cub Traditional
Youth Traditional Pee Wee(7 & under)
In consideration of being allowed to participate in any way in The Johnson County Archers ("JCA") events and activities, the undersigned acknowledges, appreciates, and agrees that:
1.The risk of injury from archery and other known events and activities and/or the use of the related buildings, structures, equipment, automobiles, firearms, weapons, ATV's, boats, tree stands, roads, bodies of water, land, and all other real and personal property whether owned by the archery club or others is significant, including the potential for permanent paralysis and death, and while particular rules, equipment, and personal discipline may reduce this risk, the risk of serious injury does exist; and,
2.I acknowledge and agree that the use of archery equipment, firearm and other weapons by myself or others on club premises or otherwise are inherently dangerous and high risk activities whether such archery equipment, firearms or weapons are discharged by myself or others; and,
3.I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and assume full responsibility for my participation; and,
4.I willingly agree to comply with the stated and customary terms and conditions for participation. If, however, I observe any unusual significant hazard during my presence or participation, I will remove myself from participation and bring such to the attention of the nearest official immediately; and
5.I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS The JCA, its officers, directors, officials, agents, employees, volunteers, members, guest, other participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and lessees of real property and personal property used to conduct the events and activities ("RELEASEES"), with respect to any and all injury, disability, death, OR LOSS OR DAMAGE TO PERSON OR PROPERTY, whether arising from the negligence of the releases or otherwise, to the fullest extent permitted by law.
I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.
This is to certify that I, as parent/guardian with legal responsibility for this participant, do consent and agree to his/her release as provided above of all the Releases, and for myself, my heirs, assigns, and next of kin, I release and agree to indemnify and harmless the Releases from and all liabilities incidental to my minor child's involvement or participation in these events and activities and/or the use of related real and personal property as provided above, EVEN IF ARISING FROM THEIR NEGLIGENCE.
__________________________________________________________________ ________
Parent/Guardian's Name (please PRINT)Parent/Guardian's SignatureDate Signed
This form must accompany any minor child, under the age of 18 years, attending any event held by the JCA when, the accompanying adult does not have legal authority to sign the RELEASE OF LIABILITY AND RISK OF ASSUMPTION AGREEMENT. ALL MINORS MUST BE ACOMPANIED BY AN ADULT WHILE ON THE GROUNDS!
Click the link to the right for the Official Pre Registration Slip
If you are unable to open the file select the text below and print.
